Antibiotic-impregnated envelopes reduce the rate of surgical site infection in deep brain stimulation pulse generators: a comparative study.
Acta Neurochir (Wien)
; 166(1): 318, 2024 Aug 02.
Article
en En
| MEDLINE
| ID: mdl-39090257
ABSTRACT
BACKGROUND AND PURPOSE:
Deep brain stimulation (DBS) is a surgical procedure that has been used to treat a variety of neurological disorders including Parkinson's disease, essential tremor, and dystonia. While DBS is generally considered safe and effective, surgical site infections (SSIs) are a potential complication that can lead to significant morbidity and mortality. Our objective was to investigate the use of antibiotic-impregnated envelopes (AIEs) encasing implantable pulse generators (IPGs) to reduce the rate of infection at IPG sites and the costs.METHODS:
We conducted a retrospective analysis at a single center encompassing all procedures involving the placement of Implantable Pulse Generators (IPG), including both initial insertions and replacement surgeries. The study period spanned from January 2017 to May 2024. Starting in 2020, the routine utilization of AIE became standard practice at our institute for both primary DBS implantation and IPG replacements. Surgical techniques remained consistent, pre- and post-operative antibiotic protocols were standardized throughout the study period and all cases were undertaken by a single surgeon.RESULTS:
178 patients were included and the overall incidence of IPG SSIs was found to be 1.7% (1 infection in 58 patients; 20 primary IPG/38 IPG replacements) among those who received an AIE compared to 5% (6 infections in 120 patients; 36 primary IPG/84 replacement IPG) in patients where no AIE was utilized. This resulted in an odds ratio for infection that was 2.9 times higher in the absence of AIE. The decrease in infection rates was observed in both primary and replacement IPG implants. Notably, over 80% of patients with IPG infection required surgical intervention. The use of AIE further resulted in significant cost savings.CONCLUSION:
To our knowledge, this is the largest series reporting the efficacy of Antibiotic impregnated envelope (AIE) in modifying infection rates associated with both initial and replacement Deep Brain Stimulation (DBS) Implantable Pulse Generators (IPGs). The implementation of AIEs led to a decrease in the occurrence of IPG-related infections, observed across both primary implantations and replacement surgeries, with associated economic benefits.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Infección de la Herida Quirúrgica
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Estimulación Encefálica Profunda
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Antibacterianos
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Acta Neurochir (Wien)
/
Acta neurochir
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Acta neurochirurgica
Año:
2024
Tipo del documento:
Article
País de afiliación:
Reino Unido
Pais de publicación:
Austria